Dentalwise, LLC
Organization Active NPI Dentist · Lithia Springs, GA
NPI 1316366271 · NPPES record last updated Apr 8, 2014
Key facts
- NPI
- 1316366271
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- Legal business name
- DENTALWISE, LLC
- Practice address
- 2635 Lee Rd Ste C4
Lithia Springs, GA 30122-3356 - Phone
- (770) 489-9141
- Fax
- (770) 489-9138
- NPI assigned
- Apr 8, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Randall Little
- Title
- Owner
- Phone
- (770) 853-9244
Practitioners 2
-
Kiristi Norman, DDS
-
Jeanette M. Young, D.D.S.
National Provider Directory
Locations
2635 Lee Rd
Ste C4
Lithia Springs, GA 30122
Phone (770) 489-9141
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | Yes |
Addresses
Primary practice location
2635 Lee Rd Ste C4
Lithia Springs, GA 30122-3356
Mailing address
2635 Lee Rd Ste C4
Lithia Springs, GA 30122-3356
Phone (770) 489-9141
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003141558A | Medicaid | GA |
Other providers in Lithia Springs, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.